Chan JYW, et al. - This research was designed in order to examine the efficacy of salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma (NPC) via the endoscopic endonasal approach, with the aid of a three-dimensional (3D) high-definition endoscopic system. This system resulted in an improvement of the precision of endoscopic nasopharyngectomy, especially when dissection of the internal carotid artery and dura was warranted.

Methods

• The authors enrolled 30 patients with recurrent NPC, between 2016 and 2017.
• This was follwed by recording of the patient demographics, tumor characteristics, and perioperative data.
• An analysis was carried out of the instrument ergonomics and perceived advantages by the operating, assisting, and observing surgeons.

Results

• Maximum (70%) patients received radiotherapy alone as the initial treatment for NPC, and tumor recurred after a mean interval of 16.8 months.
• It was noted that the tumor (T) classifications of the recurrent (R) tumors were: RT1: 46.7%; RT2: 33.3%; and RT3: 20.0%.
• The mean operative time was determined to be 293.3 minutes, and no conversion to open approach was warranted.
• Nine patients requirecd internal carotid artery dissection and 6 patients needed the resection and repair of dura.
• The most common method of reconstruction was discovered to be the free vastus lateralis flap (46.7%). In 73.3% of patients, microscopically clear resection margins were achieved.
• The mean hospital stay was 6.8 days.
• No reports were yielded with regard to the hospital mortality.
• One patient developed minor secondary hemorrhage.
• In contrast, the other developed transient contralateral vocal cord paralysis.
• Surgeons observed a prominent advantage of the 3D system with regard to depth and size perception, anatomy identification, and hand-eye coordination, on quantitative assessment.
• On the other hand, no substantial variation was reported with regard to the strain sensation and dizziness.